Mammograms at Newton-Wellesley Hospital

Mammograms are critical in the early detection of breast cancer and non-cancerous breast abnormalities. Serving communities throughout Greater Boston– Newton, Wellesley, Natick, Dedham Framingham, Waltham, Watertown, and more – The Women’s Imaging Center at Newton Wellesley Hospital provides both screening and diagnostic mammograms to detect a wide variety of breast conditions.

Schedule a MammogramTo schedule an appointment at the Women's Imaging Center or at our Natick or Walpole Ambulatory Care Centers, please call 617-243-5345. We offer screening mammograms multiple locations: Newton-Wellesley Hospital and at two off-site Ambulatory Care Centers in Natick and Walpole.

Types of MammogramsMammograms: A mammogram is used to detect and evaluate breast abnormalities. It is used to screen women who have no breast complaints or symptoms and it is generally the first imaging evaluation chosen to evaluate abnormal breast signs or symptoms such as a lump, pain or nipple discharge. All mammograms performed at Newton-Wellesley Hospital are digital mammograms which use X-ray detectors and a computer to create the image.

Screening mammograms: A screening mammogram is an exam used to evaluate breast tissue in women experiencing no symptoms. Mammography is very important in early detection of breast cancers because it can show changes in the breast before a patient or physician can feel them.

Diagnostic mammograms: A diagnostic mammogram is the term used to describe the mammographic images obtained when the patient has a problem discovered by her physician or by herself. It is tailored to evaluate the problem.

Safety of MammogramsAt Newton-Wellesley Hospital we take special care during X-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation.

Today’s state-of-the-art X-ray systems have tightly controlled X-ray beams with significant filtration and dose control methods. Although there is no radiation that reaches the uterus during a mammogram, we do not perform routine mammograms on women who might be pregnant.

When to Have a MammogramNewton-Wellesley Hospital recommends that annual mammograms should begin at age 40 and continue on an annual basis for all women.

If a woman has a first degree relative (mother or sister) who has been diagnosed with pre-menopausal breast cancer, however, you should start screenings 10 years prior to the age of your relative’s diagnosis. For example, if your mother was diagnosed with breast cancer at age 45, you should begin screening at age 35.

I don’t have any risk factors that I know of for breast cancer. At what age should I begin having mammograms?
The American Cancer Society, American College of Radiology, American College of Obstetrics and Gynecology as well as other organizations recommend beginning regular mammograms at 40. The risk of developing breast cancer increases with age. While some believe that screening women in their 40s is not cost effective, decades of experience and data show that screening mammography significantly lowers the death rate from breast cancer in all women including those in their 40s.

Younger women tend to have dense breast tissue which can make early cancers difficult to detect. Fortunately, digital mammography has significantly improved our ability to detect cancer in women with dense breasts. Breast cancer is unfortunately too common, even in women in their forties without risk factors. We strongly believe that being able to detect and treat breast cancer effectively in a 40-year-old woman is worthwhile. We encourage women to discuss this decision with their physician. Once you have decided that you want to be screened, you should have a mammogram every year.

I am 42 years old and I want to be screened for breast cancer. Do I need a mammogram every year or every other year?We recommend that patients have a mammogram every year. Screening mammograms are performed to detect breast cancer when it is still small. If cancer develops and it gets an extra year to grow, we are giving up an important advantage. Also, when cancer develops in a younger or premenopausal woman, it may grow faster so it is even more important for younger women to have yearly mammograms.

Breast Self-Exams and LumpsI have been getting regular mammograms. Do I still need to do breast self-examination?Absolutely. A mammogram is the best single examination to detect breast cancer. It will detect 85 to 90 percent of cancers before they can be felt. However, that also means that 10 to 15 percent of cancers can be felt before they are seen on a mammogram. Cancers may be hidden on a mammogram by surrounding breast tissue, and in these situations self examination is crucial. It is a myth that by the time breast cancer can be felt, it’s too late. This is simply not true. If you feel a change in your breast, bring it to your physician’s attention.

When I check my breasts, they feel lumpy. How can self examination help if I don’t know what a cancer lump feels like?Many of our patients are frustrated by the fact that their breasts feel lumpy. We recommend that they approach self examination with a different perspective. Don’t examine yourself with the idea of finding a lump. All breasts feel lumpy to varying degrees. Instead, check your breasts regularly enough to know how they feel. Then, continue checking to make sure they feel the same as they always have. If you notice any changes, share them with your physician because there is a possibility that you have detected an early cancer.

Your MammogramHow do I prepare for my mammogram? On the day of your exam, do not use powders, lotions, creams or ointments on your breasts as this can make the images more difficult to interpret. We recommend you wear a two-piece outfit because you will need to undress from the waist up.

We will bring you to a private changing room where you will be asked to change into one of our specially designed gowns. You will be brought into a mammography exam room where the technologist will ask for and/or update your medical history.

The technologist will explain the exam and answer any questions you may have. Please let the mammographer know if you have any scars on your breasts, breast implants or skin irritations, particularly in the fold under the breast.

The technologist will work with you to make sure your breast is positioned appropriately so that deep breast tissue can be imaged.

Some women with sensitive breasts may experience discomfort. If possible, we recommend scheduling the procedure when your breasts are least tender which generally coincides with the end of the menstrual flow.

You will be asked to change positions slightly between images. Routine views are top-to-bottom and oblique side views.

Why do you have to compress my breasts during the mammogram?Compressing the breasts is necessary so we can get the most accurate results during your mammogram. Compressions even out breast thickness, spread out tissue so we can view small abnormalities, allow us to use a lower X-ray dose because breast tissue is thinner and hold the breast still to eliminate blurring. Compression also ensures that X-ray scatter is reduced for a sharper picture quality.

How long is my mammogram? It only takes a few minutes to acquire the mammogram. However, expect to be with the technologist for approximately 30 minutes. In addition to acquiring the images, she will update your history, inspect your breasts for any scars or moles that the radiologist should be aware of, and record any complaints or concerns you may have.

Being Called Back For Additional TestingIf I have to have additional mammogram views, does this mean I have cancer?The vast majority of women who have extra views do not have cancer. It is our responsibility to be exceedingly thorough and to evaluate any suggestion of changes on a mammogram. Taking additional views will often help determine if an area of concern is present. Common reasons for additional views include:

Overlapping tissue – A mammogram is a two-dimensional picture of a three-dimensional object. Breast tissue can overlap making it look like a mass is present. Taking another view will often help determine if that’s the case.

Calcifications – Calcium deposits in the breast are common and mostly due to benign conditions, but sometimes calcifications can be an indication of cancer. Magnified views can help the radiologists determine which type of calcification is present.

Masses – To determine if a mass seen on a mammogram is suspicious, the radiologist needs to see the borders of the mass. Extra views may be necessary to see all sides of the mass more clearly.

Motion – Even slight movement by the patient can cause an image to be blurred. This occurs on less than one percent of patient's films. The image must be repeated to make sure details can be seen.

Anatomical factors – Sometimes a patient's own physical build can make it difficult to obtain a clear picture of all the breast tissue. Additional views are obtained to see areas of the breast that cannot be seen well on standard views.

A breast ultrasound, breast biopsy or breast MRI may be recommended as a follow-up to this examination:Breast MRI: May be used in addition to mammography and ultrasound in select cases. MRI is not an alternative to mammography. Radiologists at the Center determine when additional testing is necessary and will recommend breast MRI when appropriate. An MRI can be very helpful in evaluating patients newly diagnosed with breast cancer to assess the extent of the disease and plan the most appropriate treatment plan. Breast MRI is also important as a screening examination for women with very high risk of developing breast cancer because of hereditary or other factors.

Breast Ultrasound:If an area of concern is seen on a mammogram or if a lump is felt on physical examination, then further study is needed. Breast ultrasound can be helpful in characterizing lumps that are felt as well as determining if a mass seen on a mammogram is solid or cystic (fluid-filled). This information is important and helps determine if a biopsy is necessary.

Breast Biopsy:The breast imaging specialists at the Women’s Imaging Center are experts at performing breast biopsies using mammography, ultrasound or MRI to guide them. These biopsies are performed using only local anesthesia, and patients can drive themselves to and from the Hospital. The use of image-guided biopsy allows precise targeting and sampling of abnormal tissue to achieve a definitive diagnosis. Pathology results are usually available 24 to 48 hours after the procedure. Thanks to image-guided biopsies, many women can avoid surgery.

ResultsThe Women’s Imaging Center at Newton-Wellesley offers two options for your screening mammograms: screening mammograms with same-day results or results in five business days.

Same-Day Results: The Center offers screening mammograms with same-day results, which may require extended time at the Center. (This option must be requested when you schedule your appointment.) If there is a finding that requires further evaluation, you will have the option of same-day testing including additional mammography views and breast ultrasound if necessary. If a needle biopsy is required, it can be performed that day when circumstances permit.
Results in Five Business Days: If patients choose not to wait for same-day results, they will receive their mammogram results within five business days. This appointment does not require any additional waiting time once your mammogram is complete. If additional testing is needed, you will be contacted and scheduled for an appointment as soon as possible. Your referring physician is an important member of our team. We will notify your physician of test results and discuss your treatment plans. We make sure each woman is evaluated individually and that further breast care is customized to her needs and the findings on her breast studies.

How do I request my mammogram images/films? Please contact Newton-Wellesley’s Image Service Center at 617-243-6071.The Image Service Center requires a minimum of 24 to 48 hours turn-around time for film and/or image copying.